Malaria Anhang
[P.P. Wells]
INTERMITTENT FEVER
By this term we mean a disease, the
nature of which is to appear in paroxysms which recur at intervals with
intervening periods of freedom from the paroxysmal phenomena, these periods
being of various duration in different cases. The paroxysms, when perfectly
expressed, are made up of four elements: the phenomena of the circulation,
chill, heat, and perspiration, appearing in succession, the three last in the
order named, and have, in the complete form we are now contemplating, a certain
symmetry of proportionate duration and intensity in relation of each to the
other. This disease is the result of the action of a specific poison on the
human organism.
It attacks all classes and
conditions of men who are exposed to its action with perfect impartiality. The
duration of its effects is not subject to any self-imposed limitation,
but continues till the life of the
patient is destroyed or the action of the poison is conquered by appropriate
means. But the manifestations of the presence and action of this poison are not
always met in the perfect, symmetrical paroxysms. On the contrary, these are
oftener than otherwise very irregular, either in the comparative duration or
intensity of the different paroxysmal elements, or any one or two of these may
fail of appearance in any given case, or these may change the order of their
appearance in any possible order of succession, or any two of these elements
may be mixed, appearing at the same time, or may be alternated in repeated
succession for a longer or shorter time.
Or instead of the fever as
described, there may be, as a result of this poison, a variety of affections,
more or less painful and annoying, appearing as rheumatism, neuralgia,
dysentery, etc. But in whatever form the effects of this poison may appear, it
is a peculiarity of each that it is, characterized by this one feature of
periodicity.
The origin of this poison was
formerly charged to the presence of stagnant water in the infected locality (in
swamps and marshes). But it chanced there were many of these localities where
there were no cases of ague. Then decomposing vegetable matter was added as
another factor in its production, and these two combined were credited with the
origin of the whole evil. But observation has fully established the fact that
there are many localities where these are both present, and yet there are no
malarial fevers.
And more than this, some of the
localities where the fever is met in its most malignant form have neither of
these elements present as a generating cause.
Such are the Walcheren District, in
Holland, and the high, arid desert in Central Spain, and many others. So that,
while it is known and admitted that these two are active agents in producing
this poison in some localities, there are others where they are absent, and yet
the fever is there met at its worst. It follows, then, that there are other
factors producing this poison, of
which at the present time but little is known beyond the facts which result
from its action. And more than this, there are localities where,
after the absence of agues from time
immemorial, they suddenly appear, while all external circumstances, so far as
these can be appreciated, remain the same as
they have ever been. And then it has
happened, where agues have so suddenly appeared, the generation of the poison
has extended in a given direction, say from west to
east, as of late years on the north
shore of Long Island Sound, each year adding new territory to the dominion of
the disease, till large districts of country are invaded
which but lately were wholly exempt
from the plague.
Such facts plainly declared that, as
to the etiology of ague, there is much still remaining unknown. It is not
uncommon to refer the facts just stated to telluric influences
of some sort, which only leaves the
whole subject in the same darkness as before, in which notwithstanding this
attempted explanation, it is likely to remain till it can be
further shown what is the kind and
nature of this influence so charged. At present, certainly, we know nothing
about this branch of causation, and we should know nothing
of the existence of the poison so
mysteriously produced but that its existence is revealed to us by its effects.
The prevalence of the poison is more common in warm latitudes than in cold, and
yet in these there are many localities where there is no ague. Where it is
present, its production and the intensity of its action are favoured by
increase of heat, as well as in swampy districts, by drying the surface, which
is usually wet, and by its being wet again after being dried. In such
localities the fall of rain is often followed by increase of agues. It is
notable that though in these cases water seems to play so important a part in
the production of the cause of these fevers, yet they prevail in others where
there is little or no water, and where this agent can be supposed to have had
little to do in the production of their cause.
A notable example of this is met in
the high sandy plains of Spain. In this and the dry localities of Italy and
Greece the fall of rain is followed by abundant malaria.
This has been attributed to the
ammonia present in the water of the rainfall, which is, of course, merely
hypothetical. It is also worthy of remark that in many localities, notably in
mountainous regions, in spite of frequent exposure to chills, and of extreme
changes of temperature from hot days to cold nights, and the greatest exposure
of persons, there are no intermittent fevers, while, on the contrary,
localities where the greatest evenness of temperature prevails, the sickliest
months are those which show the least variation. The production of the poison
is modified by the quantity of water present in the infected locality. Where
the water is deep it is less, and more where it is shallow.
The facts stated above and many
others show conclusively that while water, decomposing organic matter, and high
temperature are active factors in the genesis of ague poison in many instances,
in others, where these are mostly or wholly absent, the poison is present and
active in a notable degree.
From this it may be accepted with confidence
that there are other factors which originate the poison in question, either
conjointly with these, or, in some localities, apparently independent of them.
As to just what these last factors are, we may speculate as much as we please,
and at the end remain in ignorance.
[Dr. Von Bnninghausen]
1st. The examination of the patient
as to the time and periodicity -the various stages of paroxysm- the concomitant
symptoms of each stage and the symptoms predominating during the apyrexia.
2nd. The selection of the remedy.
The truly curative remedy may be indicated by the time and periodicity:
10 h. Nat-m.
16 h.: Lyc.
Morning: Nux-v.
Afternoon: Apis
Periodical: Lach. Cact. Nit-ac.
At the same hour every day: Sabad.
Aran.
Thirstless: Puls. China. Sabad.
Thirst before the chill: Eupat-per.
Ars. Chin. Puls.
Thirst only during the chill: Caps.
Carb-v.
Thirst between chill and fever:
Chin. Sabad.
Thirst during the fever paroxysm for
large quantities of cold water at a time: Bry.
Thirst for small quantities at a
time: Ars. Lyc.
Paroxysm + headache: Nat-m.
Headache after paroxysm: Apis.
Fever + sleep as under: Apis. Gels.
Cact. Dr. von Bnninghausen's excellent essay on "Intermittent Fever"
for more minutiĉ.
3rd. The remedy properly chosen
should be administered very soon after the paroxysm is over and only during the
apyrexia, never during the paroxysm. If the next paroxysm
is not changed in any way either as
to time or in its concomitant symptoms, and if no new symptoms belonging to the
remedy have been developed, our choice of the remedy may be supposed to have
been faulty. If the paroxysm changes as to time and the next attack comes on
earlier, we may reasonably expect an improvement and should not repeat the
remedy; if the next attack is accompanied by symptoms characteristic of the
remedy, or if the attack is lighter we should not repeat the remedy If the
attacks continue but are lighter each time, we may safely wait on the effects
of the medicine given. If the attacks continue and the symptoms having guided
us in the selection of
the remedy cease, then we must
choose another remedy. We must follow implicitly Hahnemann's rule - not to
repeat the dose or give a new remedy until the effect of the former dose is
exhausted.
[Dr Constantine Hering/Sylvain
Cazalet]
In marshy places: Arn. Ars. Carb-v. Chin. Cina. Ferr-met. Ip. Nat-m. Rhus-t. Verat.
In damp, cold seasons: Calc. Carb-v.
Chin. Lach. Nux-m. Puls.
Rhus-t. Sulph. Verat.
In spring and summer: Ant-t. Ars.
Belladonna, Capsicum, Carb-v. Cina. Ip. Lach. Nat-m. Nux-v. Puls. Sulph. Verat.
In autumn: Bryonia, Chin. Nux-v.
Rhus-t. Verat.
Mismanaged with by large doses of
quinine: Arn. Ars. Bell.
Calc. Capsicum, Carb-v. Cina. Ferr-met. Ip. Lach. Merc. Nat-m. Nux-m. Nux-v. Puls. Sulph. Verat.
An attack every day: Acon. Ars.
Bell. Bry. Calc. Capsicum, Carb-v. Chin. Ignatia, Ip. Lach. Nat-m. Nux-v. Puls.
Rhus-t. Sulph. Verat.
An attack every other day: Ant-t. Arn. Ars. Bell. Bry. Calc. Caps. Carb-v. Cham. Chin. Ip. Lach. Nat-m. Nux-m. Nux-v. Puls. Rhus-t. Verat.
An attack every 4th day:
Acon. Arn. Ars. Carb-v.
Ignatia, Nux-m. Puls.
Verat.
An attack every 2 weeks: Ars.
An attack every year: Ars. Carb-v.
Lach.
Coming on in the evening: Acon. Arn.
Ars. Bell. Bry. Calc. Carb-v. Ign. Ip. Lach. Merc. Nux-v. Puls. Rhus-t. Sulph.
Coming on in the night: Ars. Bell.
Calc. Caps. Carb-v. Cham. Hep. Merc. Nux-v. Puls. Rhus-t. Sulph. Verat.
Coming on in the morning: Arn. Ars.
Bell. Bry. Calc. Carb-v. Cham. Chin. Hep. Lach. Merc. Nat-m. Nux-v. Sulph.
Verat.
Chill and coldness only: Bry. Caps.
Chin. Coff. Hyos. Ip. Nux-v. Puls. Verat.
Chill and heat, but no sweat: Acon.
Arn. Ars. Bell. Bry. Caps. Carb-v. Cham. Ign. Ip. Merc. Nux-v. Puls. Rhus-t.
Sulphur.
Chill and sweat, but no heat: Ars.
Bry. Puls. Rhus-t. Sulph. Verat.
Heat only, little or no chill and
sweat: Acon. Ars. Bell. Bry. Calc. Coff. Ip. Lach. Nux-v. Op. Puls. Sulph.
Verat.
Heat and sweat, but no chill: Acon.
Ars. Bell. Bry. Caps. Carb-v. Cham. Chin. Cina. Coff. Hep. Ign. Ip. Nux-v. Op.
Puls. Rhus-t. Verat.
Sweat prevailing: Acon. Ars. Bell.
Bry. Calc. Carb-v. Cina. Hep.
Merc. Nat-m. Puls.
Rhus-t. Samb. Sulph. Verat.
Chill, heat and sweat, all of the
same degree: Acon. Ars. Bell. Bry. Caps. Cham. Chin. Cina. Hep. Ign. Ip. Nux-v.
Puls. Rhus-t. Sulph. Verat.
Chill then heat: Acon. Arn. Bry.
Bell. Caps. Carb-v. Chin. Cina. Hep. Hyos. Ign. Ip. Nat-m. Nux-v. Puls. Rhus-t.
Sulph. Verat.
First heat then chill: Bell. Bry.
Calc. Caps. Nux-v. Puls. Sulphur.
Heat and chill, alternating: Ars. Bell. Bry. Calc. Chin. Merc. Nat-m. Nux-v. Sulph. Verat.
Heat and chill at the same time:
Acon. Ars. Bell. Bry. Calc. Cham. Chin. Ign. Ip. Merc. Nux-v. Puls. Rhus-t.
Sulph. Verat.
Heat and chill at the same time,
heat externally, chill internally: Acon. Ars. Bell. Calc. Coff. Ign. Lach.
Nux-v. Sulph.
Heat and chill at the same time,
heat internally, chill externally: Arn. Bry. Chin. Merc. Puls. Rhus-t. Verat.
Sweat coming on with the chill: Ars.
Calc. Nux-v. Puls. Sulphur.
Chill then sweat without heat: Bry.
Caps. Rhus-t. Verat.
Sweat and heat together: Acon. Bell.
Bry. Caps. Cham. Chin. Cina.
Hep. Ign. Ip. Merc. Nux-v.
Op. Rhus-t. Verat.
Sweat after the heat: Ars. Bry. Carb-v. Cham. Chin. Cina. Coff. Hep. Ign. Ip. Op. Puls.
Rhus-t. Sulph. Verat.
Thirst before the attack: Arn. Chin.
Puls. Sulphur.
Thirst during the chill: Acon.
Ant-t. Arn. Ars. Bry. Calc. Caps. Carb-v. Cham. Chin. Cina. Hep. Ign. Ip.
Nat-m. Nux-v. Rhus-t. Sulph. Verat.
Thirst after the chill, but before
the heat: Ars. Chin. Pulsatilla.
Thirst and heat together: Acon.
Bell. Bry. Calc. Caps. Cham. Chin. Hep. Hyos. Lach. Merc. Nat-m. Nux-v. Puls.
Rhus-t. Sulph. Verat.
No thirst during the heat: Ars.
Bell. Caps. Carb-v. Chin. Ign. Ip. Lach. Merc. Nux-m. Nux-v. Puls. Rhus-t.
Samb. Sulph. Verat.
Thirst after the heat: Chin. Nux-v.
Op. Pulsatilla.
Thirst during the sweat: Ars. Cham.
Chin. Hep. Merc. Nat-m. Puls. Rhus-t. Verat.
Thirst after the sweat: Nux vomica.
Complaints accompanying intermittent fever
Pains in the limbs: Ars. Chin.
Nat-m. Nux-v. Rhus-t. Verat.
Great Weakness: Ars. Chin.
Ferr-met., Hyos. Lach. Nat-m. Nux-v.
Rhus-t.
Dropsical symptoms: Ars. Chin. Ferr-met.
Drowsiness and sleepiness: Bell.
Carb-v. Hyos. Lach. Op. Puls. Rhus-t.
Sleep during the chill: Nat-m. Nux-m.
Sleep during the heat: Ign.
Sleep after the chill: Ars.
Great nervous and mental excitement:
Acon. Ars. Bell. Bry. Cham. Coff. Ign. Nux-v. Puls.
Rush of blood to the head (with
giddiness, delirium, stupor): Acon. Bell. Bry. Carb-v. Glon. Hyos. Lach. Nux-v.
Op. Puls. Rhus-t.
Violent headache: Arn. Ars. Bell.
Chin. Glonoine. Ign. Lach. Nat-m.
Nux-v. Puls. Rhus-t.
Deranged stomach: Ant-t. Ars. Bell.
Bry. Cham. Chin. Ign. Ip. Nat-m.
Nux-v. Puls. Sulph.
Vomiting: Ant-t. Ars. Bry. Chin.
Cina. Ign. Nux-v. Puls.
Vomiting during the chill: Bry. Ign.
Vomiting after the chill: Ars.
Nux-v.
Vomiting during the heat: Nux-v.
Vomiting of bile: Bry. Ign. Nux-v.
Vomiting of mucus: Chin. Ign. Puls.
Vomiting of victuals: Ignatia.
Tongue coated white: Ant-t. Bry.
Nux-m.
Tongue sticky, dry, during the
chill: Bry.
Diarrha: Arn. Ars. Cham. Chin. Ip.
Puls. Rhus-t. Verat.
Constipation: Ars. Bry. Calc. Merc.
Nux-v.
Spleen, hardness of: Nux-m.
Spleen, pain in: Caps.
Liver, pains and swelling of: Ars. Chin. Merc. Nux-v.
Catarrhal symptoms (cough, etc.): Acon. Bell. Bry. Chin. Hep. Lach. Merc.
Nux-v. Puls. Rhus-t. Sulph.
Oppression of the chest and
difficulty of breathing: Acon. Ant-t. Arn. Ars. Bry. Chin. Ferr-met. Hep. Ip.
Lach. Nux vomits, Puls. Sulph.
The above accompanying complaints
are present particularly :
Before the attack: Arn. Ars. Bell. Calcarea carbonica, Carb-v. Chin.
Cina. Ign. Ip. Nat-m. Nux-v.
Puls. Rhus-t. Sulph.
During the Chill: Arn. Ars. Bry.
Calc. Caps. Carb-v. Chin. Cina. Hep. Ign. Ip. Lach. Merc. Nat-m. Nux-m. Nux-v.
Puls. Rhus-t. Verat.
During the heat: Acon. Ars. Bry.
Bell. Calc. Caps. Carb-v. Cham. Chin. Coff. Hyos. Ign. Ip. Lach. Merc. Nat-m.
Nux-v. Op. Puls. Rhus-t. Sulph. Verat.
During the sweat: Acon. Ars. Bry.
Cham. Lach. Merc. Nux-v. Op. Puls. Rhus-t. Sulph. Verat.
After the attack: Ars. Bry. Carb-v.
Coff. Ign. Lach. Nux-v. Puls. Rhus-t.
Pulse, intermittent: Ars. Chin.
Lach. Merc. Nat-m. Nux-v. Op.
Pulse, apparently wanting: Acon. Ars. Carb-v. Hyos. Op. Verat.
Pulse hard: Acon. Bell. Bry. Hyos.
Nux-v. Sulph.
Pulse small: Acon. Ars. Bell. Hyos.
Lach. Merc. Nux-v. Op. Verat.
Pulse slow: Bell. Chin. Merc. Op.
Puls. Rhus-t. Samb. Verat.
Pulse hurried: Acon. Ars. Bell. Bry.
Hyos. Merc. Puls. Sulph.
Pulse irregular: Acon. Ant-t. Ars.
Bry. Chin. Hep. Lach. Merc. Nat-m. Rhus.
Pulse full: Acon. Bell. Bry.
Ferrum, Hyos. Lach. Nux-v. Op.
Puls. Samb. Sulph.
Pulse soft: Carb-v. Chin. Verat.
Pulse trembling: Ars. Merc. Rhus-t.
Vorwort/Suchen. Zeichen/Abkürzungen. Impressum.